Problem gambling and Social Work

1. Why is this relevant?

2. How to identify this ‘hidden’ problem

3. How to help

4. Signposting.

Why is this relevant?

Problem gamblers in UK – 0.6 - 0.85% of population (Connolly et al 2017 based on Health surveys of England and Scotland)

At risk gamblers in UK - up to 2 million people have or are

at risk of developing gambling problems(Gambling Commission 2017)

Why is this relevant?

Problem gambling and debt -

Problem gambling and deprivation -

Problem gambling and intimate partner violence -

Problem gambling and families

Co-morbidities – substance misuse, mental health problems -

Problem gambling, and debt -

Average debt of problem gamblers= £16,000 (National Problem Gambling Clinic)

= £17,500 (Gam care)

(compare average of £6000 for UK residents in

2017 - Moneysupermarket)

Valentine and Hughes (2010) - debt range -£2,000 to £144,000

Thomas (2009) -average self reported debt £62,676

It is of note that gambling-related debt on the part of perpetrators

of financial abuse has been identified in a number of adult

safeguarding investigations (O’Keeffe et al.2007).

Problem Gambling and Deprivation

Those living in the most deprived areas were three times more likely to report

having a close relative with a gambling problem compared to those living in the

least deprived areas (Orford 2011)

Links between area deprivation and volume of gambling and levels of problem gambling

( Welte et al 2004 for USA and Orford 2010 and Carra et al 2017 for UK )

Relative and absolute deprivation.

Problem Gambling and ‘Domestic violence’ or ‘Intimate Partner Violence’ ( IPV)

Meta-analyses revealed that over one third of problem gamblers report being victims of physical IPV (38.1%) or perpetrators of p

(Dowling et al 2016)

Why is this relevant?

Problem gambling and families

‘it is unfortunate but likely that the children who grow up in problem gambling

families will become an important area of concern for child health and

social workers’ (Darbyshire, Oster, and Carrig 2001).

Children of problem gamblers

… reported feeling abandoned, rejected, neglected, emotionally deprived,

angry, hurt, sad, confused, isolated and/or lonely, guilty, helpless, anxious and

depressed

-They often suffered from stress

related illnesses including asthma and allergies, headaches and stomach problems

-Inadequate stress management, poor coping skills and

poor school performance were also reported among this population

-In addition, children of problem gamblers were more likely to gamble themselves

at a younger age

-Lorenz and Shuttlesworth

(1983) found that 25% of the children in their study had significant behavioural or

adjustment problems, reflected in running away from home, committing crime

and engaging in drug-, alcohol-, or gambling-related activities

(Problem Gambling and its Impact on Families: A Literature Review Kalischuk 2007)

Co -morbidities

A review of treatment seeking problem gamblers (Dowling et al 2015)

highest mean prevalence of current psychiatric disorders was for nicotine dependence(56.4%)

major depressive disorder (29.9%)

alcohol use disorders (21.2%),

anxiety disorders (17.6%,)

social phobia (14.9%,)

post-traumatic stress disorder (12.3%,)

Co-morbidities

cannabis use disorder (11.5%,)

attention-deficit hyperactivity disorder (9.3%)

adjustment disorder (9.2%)

bipolar disorder (8.8%,)

obsessive-compulsive disorder (8.2%)

What to look for? What to ask?

Straightforward Screening Tools

1. The Lie/Bet Questionnaire:

1. Have you ever had to lie to people important to you about

how much you gambled?

2. Have you ever felt the need to bet more and more money?

2. Gamcare screening tool : 16 statements

http://www.gamcare.org.uk/get-advice/self-assessment-tool

3. Gamblers Anonymous 20 Questions

http://www.gamblersanonymous.org/ga/content/20-questions

What to look for?

Finance Money missing from bank accounts, wallet/purse or money jar.

Household items and valuables missing.

Regularly short of money even though they earn a wage. Borrowing money on a regular basis

Having many loans at the one time. Being secretive about financial records or payslips

Unpaid bills/disconnection notices. Lack of food in the house.

Mood and Behaviour

Becoming withdrawn from others/family events. Performance at work is being affected

Controlling and/or manipulative behaviour. Using threats, lies or charm to manipulate others.

Reporting feeling hopeless, depressed, frustrated or suicidal

Seeming worried, agitated or upset for no apparent reason.

Changes in personality - sleeping, eating, or sexual relationship patterns

Time Spending more and more time gambling. Being secretive about unexplained absences

Often being late for commitments Taking a lot of sick days or days off

Taking an unusual amount of time for simple tasks

Specific Guidance for Social Workers?

Australian Association of social workers – position statement 2012.

https://www.aasw.asn.au/document/item/3880

Related Guidance :

http://www2.mmu.ac.uk/media/mmuacuk/content/documents/hpsc/research/Alcohol-and-other-drug-

use-report.pdf

Plans for a project to develop similar guidance in relation to PG in the next year.

Professional Capabilities

How to help?

Recognition - few problem gamblers seek help, ambivalence is high, and feelings of guilt and shameare often strong.

Motivational interviewing -

‘Motivational interviewing, or MI, has become increasingly popular in social work in recent years.This is because its values and theory are consistent with core elements of social work and it providesnew ways of understanding some of the key challenges. MI focuses on how to have difficult conversations

and there is strong evidence for its effectiveness in helping people change problematic behaviours ’(Forrester 2016).

Signposting to specialist help - see below.

Signposting

Specialist :

1.Gamcare –

National Gambling Helpline 0808 8020 133, 8am to midnight, seven days a week.

( 46,000 calls in 2015-16) and/or the Netline.

(If you are deaf or hard of hearing, you can access the helpline via a service called Next Generation Text Service. Find out more at

http://ngts.org.uk/

Also,Telephone interpretation services are provided by Language Line.)

One to one counselling – offered via partner agencies with counsellors accredited by the British Association for Counselling and Psychotherapy (BACP)

2.Gamblers Anonymous and GamAnon – 120 groups across the country

GamCare Counselling network

25 partner agencies covering much of the UK.

6,830 sessions offered in 2015/16

Signposting

National Problem Gambling Clinic

800 people per year

http://www.cnwl.nhs.uk/cnwl-national-problem-gambling-clinic/

Gordon Moody Association

Residential, online and outreach services

18 beds providing a 12 week residential programme in West Midlands and London( in 2015/16 - 479 initial applicants - 52 successfully completed 12 week programme)

Half way house and relapse prevention support for 14 ex residents x 3 months

Online

GamCare – 1.5 million visitors in 2015/16

Interactive online help and web forum

1. http://www.gamcare.org.uk/

2.Bigdeal website designed for young people.

- https://www.bigdeal.org.uk/

Gamblers Anonymous

https://www.gamblersanonymous.org.uk/

Practical Advice

CAB -

Debt advice - e.g https://www.stepchange.org/

GAMBLOCK - blocking software -http://www.gamblock.com/index.html

A range of organisations now offering advice and help in relation to problem gambling.

YGAM (Young Gamblers Education Trust) -

http://www.ygam.org/

‘independent UK-Registered Charity with a social purpose to inform, educate and safeguard young people

against problematic gambling or gaming’.

‘In 2016/17, almost 30,000 young people accessed our education programme and we worked with 348

organisations. For 2017/18, we are planning on reaching at least 100,000 young people’.

EPIC Risk Management

http://epicpgc.com/individual-support/

Working with prisons, sports bodies, and financial sector.

http://www.livingroom-cardiff.com/

References

Carrà,G., Crocamo,c. Bebbington,p. (2017) Gambling,

geographical variations and deprivation: findings from the adult psychiatric morbidity survey,International Gambling Studies, 17:3, 459-470.

Connolly et al (2017) Gambling behaviour in Great Britain in 2015.London Nat Cen Social Research

Darbyshire,P., Oster,C. and Carrig,H. (2001). The experience of pervasive loss: Children and young people

living in a family where parental gambling is a problem. Journal of Gambling Studies,17(1),23-45.

Dowling,N.et al (2015) Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis.

Australian and New Zealand Journal of Psychiatry, Vol 49(6), 519-539.

Dowling.N., et al ( 2016). Problem gambling and intimate partner violence: A systematic review and

meta-analysis.Trauma, Violence, & Abuse,17(1), 43-61.

Kalischuk, R.,Nowatzki,N., Cardwell,K., Klein,k., & Solowoniuk,J. (2006) Problem Gambling and its Impact on Families: A Literature Review, International Gambling Studies

Lorenz,V. and Shuttleworth,d. (1983) The impact of pathological gambling on the spouse of the gambler. Journal of Community Psychology 1983,11(1):67–76.

Moineysupermarket (2017) United Kingdom of Credit https://www.moneysupermarket.com/credit-cards/uk-credit-cards-report/ [accessed 10.10.17]

O’Keeffe, M et al. (2007). UK Study of Abuse and Neglect: prevalence survey report. For CR/DH and theDepartment of Health

Orford,J. et al (2010) The role of social factors in gambling: evidence from the 2007 British

Gambling Prevalence Survey. Community, Work & Family, 13, No. 3,257-71

Orford,J (2011) An Unsafe Bet? the Dangerous Rise of Gambling and the debate we should be having.

Chichester.Wiley Blackwell

Thomas, A. (2009). An investigation into the relationship between problem gambling and

debt. Unpublished MBA dissertation, University of Wales.

Valentine, G., & Hughes, K. (2010). Ripples in a pond: The disclosure to, and management of,

problem Internet gambling with/in the family. Community, Work & Family, 13(3), 273-290.

Welte, J.W., Wieczorek, W.F., Barnes, G.M., Tidwell, M.O., & Hoffman, J.H. (2004). The

relationship of ecological and geographic factors to gambling behaviour and pathology.Journal of Gambling Studies, 20, 405-423.